Chiu-Yueh Yang

Introduction: Medication nonadherence remains a major recovery barrier for community‐dwelling individuals with schizophrenia. Aim: To evaluate a theory‐based integrated medication‐adherence intervention. Method: This quasi‐experimental study included 75 participants (39 experimental and 36 control). Medication adherence (Medication Adherence Rating Scale, MARS), psychiatric symptoms (Brief Psychiatric Rating Scale, BPRS), medication adherence motivation (University of Rhode Island Change Assessment, URICA) and medication attitudes (Drug Attitude Inventory‐10, DAI‐10) were assessed at baseline, 12 and 24 weeks. Repeated‐measures ANOVA examined Group × Time interactions, change‐from‐baseline interaction contrasts and timepoint‐specific between‐group differences; rehospitalisation was assessed from medical records. Results: Group × Time interactions were significant for MARS ( p = 0.035, η _p ² = 0.047), BPRS ( p = 0.042, η _p ² = 0.045), URICA ( p = 0.003, η _p ² = 0.087) and DAI‐10 ( p = 0.004, η _p ² = 0.082). Between‐group differences in change from baseline to Week 24 were significant for all outcomes, whereas from baseline to Week 12, a significant difference in change was observed only for DAI‐10. At Week 24, between‐group differences favoured the experimental group for MARS (1.186, 95% CI [0.261, 2.111]), URICA (1.507 [0.625, 2.389]) and DAI‐10 (3.923 [1.743, 6.103]); the BPRS CI included zero. No rehospitalisations occurred. Discussion: The intervention was associated with favourable medication‐related outcomes; adherence effects were modest, symptom findings less conclusive and the non‐randomised design limits causal inference.

Background: People with schizophrenia have a higher risk of metabolic syndrome because of atypical antipsychotic side effects, a lack of exercise, and dietary intake and lifestyle behaviors. Aim: This study aimed to evaluate the sex-stratified effects of a Baduanjin qigong intervention on body mass index (BMI) and fasting blood glucose (FBG) in individuals with schizophrenia. Methods: This study involved 91 participants from three rehabilitation facilities who were randomly assigned to two groups. The experimental group (EG) practiced Baduanjin for 12 weeks and participated in 60-min sessions three times per week. Each session included a 10-min warm-up, two 20-min Baduanjin sets, and a 10-min cool-down, guided by an instructional video. The control group (CG) received standard care, consisting of 30 min of activities such as walking and dancing. Metabolic parameters and BMI were measured before the intervention, immediately postintervention, and at 3-month follow-up. Analyses were performed using generalized estimating equations (GEEs) stratified by sex. Results: Male participants in the EG exhibited significant improvements in BMI ( p = .009) and FBG levels ( p = .030) immediately after the intervention. In contrast, male participants in the CG experienced significantly worse FBG levels at the 3-month follow-up ( p = .005). No significant group differences were observed among female participants in the GEE analysis immediately after the Baduanjin program or at the 3-month follow-up, even after adjustments were made to account for covariate effects. Conclusion: Baduanjin qigong may effectively improve BMI and reduce FBG levels in male patients with schizophrenia. Trial registration: NCT04069988; www.clinicaltrials.gov .

Background: Nonadherence to treatment increases relapse and rehospitalization risks and diminishes quality of life in patients with schizophrenia spectrum disorder. Purpose: This study was developed to explore the effect of motivational interview-based cognitive therapy (MIBCT) on medication adherence, insight into illness, and psychotic symptom severity in patients with schizophrenia spectrum disorder. Methods: A single-blind, multicenter randomized controlled trial was conducted on 120 participants recruited from outpatient departments and acute psychiatric wards in northern Taiwan. The participants were randomly assigned to either the experimental group ( n =61), which received MIBCT consisting of eight sessions every 3–4 weeks over a period of 24–32 weeks, or the control group ( n =59), which received routine care and psychoeducation. The outcomes were measured using the Medication Adherence Rating Scale (MARS), the Schedule Assessment of Insight (SAI), and the Positive and Negative Syndrome Scale (PANSS) at three time points: baseline, the fourth session of interim analysis, and postintervention. Differences in between-group outcomes over time after adjusting for 13 covariates were analyzed using generalized estimating equations. Results: The mean MARS score in the experimental group improved significantly by 2.56 points at postintervention ( p <.001), with significantly lower gains reported for the control group. In addition, the SAI outcome measures for the experimental group improved more than for the control group. This was evident both during the interim analysis and postintervention, with results of B =1.85 ( p =.003) and B =2.23 ( p =.001), respectively. Furthermore, the mean improvements in positive symptoms were significantly greater in the intervention group than the control group at both the interim analysis ( B =−2.52, p =.002) and postintervention ( B =−1.85, p =.029). Conclusions/Implications for Practice: The results of this study indicate the application of MIBCT significantly improves medication adherence, insight into illness, and positive symptoms in patients with schizophrenia spectrum disorders by increasing intrinsic motivation and addressing treatment barriers. The implementation of this integrated therapeutic approach by psychiatric nurses may contribute to improved patient outcomes.

Aims: This randomized controlled trial examined the effectiveness of the 12-week NICE-Support programme—combining nutrition, nursing instruction, exercise, and support—on frailty and quality of life in patients with heart failure. Methods and results: A total of 240 adults (≥20 years) with stable heart failure, cognitive and physical capacity for activity, and smartphone access were recruited from two Taiwanese medical centres and randomly allocated to either the intervention group or the control group. The 12-week intervention included nutritional counselling, three in-person nursing consultations (40–60 min each), a structured exercise regimen (three 30 min sessions per week), social media support, and biweekly follow-up calls. The control group received standard nursing care and routine discharge education. Frailty and quality of life were assessed at baseline and at 4, 12, and 24 weeks to evaluate short-term and sustained effects. Among the 240 participants, 192 (80%) completed the 24-week follow-up. An intention-to-treat analysis was conducted to evaluate the intervention effects. Both groups showed significant improvements over time. At 24 weeks, the control group demonstrated significant improvements in frailty scores (−8.11 points) and overall quality of life scores (−22.71 points). Compared with the control group, the intervention group exhibited significantly greater improvements in frailty (Cohen’s d = 1.17) and overall quality of life (Cohen’s d = 0.87) at Week 24. Conclusion: The NICE-Support programme significantly reduces frailty and improves quality of life in patients with heart failure. Its integration into routine care is recommended. Registration: ClinicalTrials.gov: NCT 05366686

The impact of gratitude on mental health and job stability in nurses is explored in this article, with a focus on relevant challenges and potential interventions. Based on a review of the literature, gratitude is a positive psychological resource that may effectively reduce stress, enhance psychological resilience and well-being, improve the workplace atmosphere, and reduce turnover intention. Gratitude, which encapsulates the recognition and response of an individual to the goodwill of others, may be cultivated through practice in nurses to further enhance job satisfaction and professional identity. Gratitude-related interventions such as keeping gratitude journals, writing letters, engaging in team activities, and practicing meditation have been shown to significantly reduce occupational burnout and stress. For example, recording three things one is grateful for each day or participating regularly in gratitude gatherings can improve interpersonal relationships and strengthen team cohesion. However, challenges such as high drop-out rates, limited intervention formats, and significant resource demands hinder organizations from fully implementing these interventions. Various measures to overcome these challenges, including taking regular gratitude walks and establishing gratitude walls, should be implemented while also ensuring that intervention designs are adequately adapted both culturally and contextually. In summary, gratitude interventions have the potential to significantly enhance the mental health of nursing staff while promoting their job satisfaction and retention. Future efforts should concentrate on advancing gratitude education and practices, optimizing intervention methods, and helping healthcare institutions address workforce shortages.

Aim: To validate the psychometric properties of the Paediatric‐Friendly Care Assessment Scale in the Emergency Department (PFCAS‐ED) among clinical nurses.Design: A cross‐sectional study.Methods: A total of 463 emergency nurses participated in the study between May and September 2023. The participants were randomly divided into two groups to assess the psychometric properties of the PFCAS‐ED, including its reliability, construct validity, convergent validity, discriminant validity, and criterion‐related validity.Results: Exploratory factor analysis on data from the first group revealed six components of the PFCAS‐ED: paediatric/adolescent timely care and resources, child protection mechanisms and safety, paediatric emergency care competency training and practice, paediatric emergency consultation information and space, paediatric crisis management and response, and a harmless environment and actions for toddlers. These factors explained 69.408% of the total variance and exhibited strong internal consistency. This six‐factor structure and its 28 items were further validated using confirmatory factor analysis on data from the second group, yielding satisfactory fit indices and convergent and discriminant validity. Additionally, the scale exhibited excellent 2‐week test–retest reliability and criterion‐related validity.Conclusion: The PFCAS‐ED had excellent psychometric properties when used with clinical nurses and was proven to be a reliable instrument for evaluating emergency nurses' perceptions of the importance of providing paediatric‐friendly care to children and their families.Implications for the Profession and Patient Care: This standardised scale enables nurses to assess their perceptions of the importance of paediatric‐friendly care and design targeted interventions on the basis of available resources. Additionally, hospital administrators can use the PFCAS‐ED to identify priorities, strengths, and areas requiring improvement in paediatric emergency care, thereby informing the development of effective strategies and comprehensive policies.Reporting Method: This study adhered to the STROBE guidelines.Patient or Public Contribution: No patient or public involvement.

Background: Prolonged depressive symptoms in individuals with schizophrenia not only diminish their quality of life but also significantly increase their risk of suicide. This, in turn, may lead to a lower average life expectancy among people with schizophrenia compared to the general population. Purpose: This study was designed to examine the effectiveness of rumination-focused cognitive behavior therapy (RFCBT) on depressive symptoms in individuals with schizophrenia. Methods: This study was conducted between July 2019 and March 2020. Seventy-seven participants, all of whom had been diagnosed with schizophrenia, were randomly divided into the experimental group (n = 38) and control group (n = 39). The experimental group underwent a 12-week, six-session RFCBT regimen, whereas the control group received six sessions of psychosocial education. Outcomes were measured using the Beck Depression Inventory-II and the revised short form of the Chinese Response Style Questionnaire at three time points: baseline, postintervention, and at the 3-month follow-up. Statistical analyses were conducted using chi-square tests, independent t tests, and generalized estimating equations, with the generalized estimating equations model assessing between-group differences over time after adjusting for 13 covariates. Results: No effect on depressive symptoms was observed immediately following RFCBT. However, at the 3-month follow-up, the mean Beck Depression Inventory-II score had reduced significantly in the experimental group (from 17.24 to 15.56) and increased in the control group (from 17.59 to 23.03; p = .016). Chinese Response Style Questionnaire-10 scores, which are used to represent ruminative responses, did not differ significantly between the groups at any of the three time points. Conclusions/Implications for Practice: These findings offer compelling preliminary evidence in support of RFCBT as a potentially effective treatment strategy for alleviating depressive symptoms in patients with schizophrenia. The efficacy of RFCBT was demonstrated in terms of preventing the exacerbation of depressive symptoms. The findings have notable implications for clinicians, researchers, and policymakers with regard to developing more effective treatment strategies and enhancing outcomes for individuals with schizophrenia.